Six things to know about Ontario’s controversial medical condition report system

A program meant to make the roads safer is suspending the licences of some drivers who pose no threat.

Thestar.com
Dec. 5, 2022
Robert Cribb, Max Binks-Collier and Delcon Keogh

Medical condition reports (MCRs) take thousands of Ontarians off the road each year. In many cases, they can help make our roads safer. But the program also suspends the licences of some drivers who pose no threat, imperiling livelihoods and sowing distrust in the health-care system, a Toronto Star/Investigative Journalism Bureau investigation has found.

Here are six things you should know about Ontario’s controversial MCR program:

What are medical condition reports?

Medical condition reports (MCRs) are forms that physicians, nurse practitioners, and optometrists must send to Ontario’s Ministry of Transportation (MTO) when their patients have certain “high risk” health conditions considered to “warrant a licence suspension.” Upon receiving MCRs about these conditions, the MTO automatically suspends the patient’s driver’s licence.

These health professionals may also send MCRs about other conditions to the MTO when they have concerns about a patient’s ability to drive safely. In these cases, the MTO does not automatically suspend a driver’s licence.

Occupational therapists can report patients but don’t have to.

Who decides whether a medical condition impacts fitness to drive?

Ontario law specifies the medical conditions that must be reported. They include certain psychiatric issues, cognitive impairments, uncontrolled substance use disorders where patients don’t comply with treatment, and others.

When assessing drivers with medical conditions that health professionals have voluntarily chosen to report, ministry officials say they consult medical standards set by the Canadian Council of Motor Transport Administrators.

Are health professionals required to inform patients before they file MCRs to the Ministry of Transportation?

No. While the Ministry of Transportation and College of Physicians and Surgeons of Ontario advise health-care providers to inform their patients prior to filing an MCR, there is no requirement to do so. In many cases, drivers only learn of their suspension when they receive a letter from the ministry, sometimes weeks after their interaction with a health-care professional.

How common are medical condition reports?

Between April 2011 and the end of 2020, physicians in Ontario filed just under 350,000 MCRs, according to Ministry of Health data obtained by the Star/IJB. On average, more than 35,000 MCRs were filed by doctors each year.

These figures do not include MCRs filed by nurse practitioners, optometrists and occupational therapists.

What can drivers do to challenge a licence suspension they feel was unfair?

Drivers can typically apply for reinstatement of their licence by having a health-care provider submit paperwork to the MTO about their condition. Sometimes, however, the ministry makes people wait before it will reinstate their licences. For example, patients whose licences are suspended for an alcohol use disorder must undergo a year of confirmed abstinence. This can be shortened to six months if they also attend a treatment program and have a health-care provider who is supportive of their licence reinstatement.

Drivers can also turn to Ontario’s Licence Appeal Tribunal to challenge the suspension, though it costs $106 to file an appeal. A Toronto Star/IJB review of nearly 200 appeals found that about one third of appeals overturned the suspension. In approximately a quarter of successful appeals, the MTO could not prove the drivers ever had the medical conditions upon which their suspension was based.

Is reporting drivers with potentially dangerous medical conditions mandatory in every province?

No. In some Canadian provinces, like Ontario, medical professionals are required by law to report certain patients. In other provinces, such as Alberta, medical professionals are under no such obligation. Instead, they can choose to report patients whose driving is cause for concern. Under British Columbia’s legislation, health-care providers are only required to report patients who they believe have a dangerous medical condition and continue to drive “after being warned” not to.